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Advances too rarely implemented

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Clinical evaluations sometimes provide convincing evidence that a particular strategy offers tangible benefits for patients. To what degree do patients benefit from these advances? Convincing evidence not translated into practice. The independent clinical trial ALL-HAT, which compared various antihyperten-sive drugs in more than 40 000 patients followed for over 5 years, showed that the first-choice drug for hypertension is a thiazide diuretic (1). Yet the significant impact on prescribing in the short term was not sustained (2). An independent trial published in 1991 showed that taking folic acid one month before conception and during the first trimester of pregnancy reduces the risk of neural tube defects in the unborn child (3,4). In the United States and Canada, the addition of folic acid to staple foods, including flour, led to a decline in the frequency of these defects from 11 to 6 cases per 10 000 pregnancies (3,5). In Europe, on the other hand, data from 18 European countries showed that, between 1991 and 2011, the prevalence of neural tube defects remained stable at 9 cases per 10 000 pregnancies (births, fetal deaths and terminations of pregnancy) (3).

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    《Prescrire international》 |2016年第175期|228-228|共1页
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  • 正文语种 英语
  • 中图分类 药学;
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